Nursing Education in the Developing World: Looking Ahead and Preparing
This blog post was written by Ayinla Daniel, RN, blogger, writer, digital health enthusiast, and founder of Care City, an online community built around the core idea that nurses should do more in the adventurous world of healthcare innovation and leadership.
In this short article, I bring forth an argument that advocates for a change in the nature of nursing education in the developing world. I have written from my purview, my exposures, and experiences as a nurse educated under these same educational systems that I now criticize. The center of my idea in this article is simply built around the theory that we, in the developing worlds, should allow nursing education to evolve naturally, while we cautiously prune away the excesses that may spring forth as it matures - learning from those who are getting it right.
The Beautiful Roads of True Nursing Education
Ancient Rome, went from being a small unrecognized village, rearing livestock in the hills, to being/becoming the most powerful empire of the middle world.
Do you know what made it possible for Rome to achieve this? Roads!
Yes, Rome built roads that connected them to other neighboring empires, that were busy building cities within mighty walls. With the roads, Rome transported their armies and took Kingdoms.
Accurate nursing education is the golden road that connects one generation of nurses to another.
I see nursing education as the medium that should convey the very essence of nursing practice. And this is why I have reverence for those who have taken it upon themselves to educate nurses - not just in the world of nursing, but in other fields.
Teachers should be respected; for in their hands, they wield the ideas that forge the minds of the future.
We must understand that nursing education is way beyond classrooms and lecture notes. Nursing education is the embodiment of the ethos that defines the core values of the nursing profession. We are nurses, simply because of the type or kind of education we received while we were studying. And many of us are still students, learning at various levels in different forms of institutions. Tomorrow, the kind of nurses we become will be largely due to the kind of education we received while we were yet students.
To me, true nursing education has, within its very core, the message of leadership. Besides, what should education do to a man, if not to make him a better fellow by putting in him the idea that he is worth it? If the nursing education that you are receiving, or have been receiving, does not build in you the confidence of a leader, then I admonish you to abandon it, for it isn't doing you any good at all.
What the Western World Gave Us
We inherited nursing education, like every other element of our civilization, from the Western world. Professional nursing, they say, started when Florence Nightingale, the acclaimed mother of modern nursing, shot the profession into the limelight through her heroic efforts in the Crimean War. The same model of nursing education that she passed on to us, in its purest form, is what still makes the bulk of our education in developing countries. While in more advanced countries, many have refined these educational standards, infusing them with the sophistication that surrounds the modern world, and adapting them with the socio-cultural, economic, and political changes that have engulfed us as a civilization.
But alas, we, here in the developing worlds, have not been able to go further. We still consume the raw form. Should I say we have refused? Or, we do not deem it necessary to advance in the way we think?
We still run a Nightingalean form of nursing curriculum. Oh, we may have academic institutions now running degrees for nurses; but tell me, when did these institutions arrive at the academic scenes? Or, how are these institutions being managed? Do they make it easy for nurses to quickly and easily migrate to the arena of the academic world?
And although these degrees were originally designed to make us look advanced and sophisticated, the trace scent of the ancient mentality of an outdated style of nursing education can still be picked up as we walk by. It will take some time for us to truly advance.
It took too long for us to start embracing the modernism that comes with the Digital Age here in developing countries. Many young nurses here can't intelligently articulate what their professional roles as nurses are. They see themselves as subordinates, trained to serve the wills of physicians, following orders without questioning why, how, or what. This mentality is ingrained in them because of the type of nursing education that they received while in school studying, and it will take some time for them to grow out of these skins made for them by ideas, philosophies, and theories that do not help them become the nursing leaders that they should be.
How can our voices be heard or respected if we still tenaciously hold on to expired ideas and philosophies, while refusing to embrace the culture of research, innovation, and creativity, which are the elements that have the power to cause the change that we deserve?
Modern Ideas, Future Breakthroughs
What really is the argument here? It's simple; let us allow the education that shapes us as a profession to evolve.
Recent developments, like the introduction of advanced practice nursing, nurse practitioners, and doctors of nursing practice, are improvements that we are excited about. These developments show us that nursing education can, and should, evolve beyond the boundaries that culture and tradition have built around it for years.
Now, in developing worlds, there seems to be a kind of light shining over us, revealing the paths to us. For too long, we have been captives of systems and methods that kept us in one spot. We were not growing or making any significant improvements in the area of nursing education. Why is it taking us so long to turn traditional Schools of Nursing that award Diplomas into degree-awarding institutions? Look closer, you will see for yourself that there are elements that have deliberately placed their heels on the neck of progress of nursing education in developing countries, especially in Nigeria. But today, something is already happening. Young nurses in developing worlds have started to understand that the future of nursing is in their hands.
Many may travel to developed countries seeking greener pastures or to get educated, as the case may be, but that does not take away their origin, where they have come from. They are still obligated, in one way or the other, to give back to the countries that made them.
It is good that we travel far away from home to other places, to see how things are done out there. Learn the educational culture, understand it, and at the end, come back home to give back.
If we were to start advocating for the adoption of advanced practice nursing here, in some parts of Africa, the physicians would immediately begin to think that we want to usurp authority (as usual). They would never think of the greater good; instead, they would allow the age-long hubris, that has always been the motivation behind their actions, to take control, and this is an important reason why we must advance by all means.
Nursing education here, in the developing world, still has a long way to go. We may be making some progress in copying the developed world's system, but just copying is not enough, we must do more than that.
Though I see a struggle with authorities, policies, and internal enemies, yet, it is not impossible to create a nursing educational system in developing countries that first is concerned with developing the leadership qualities of every nurse before it does any other thing. I am not advocating for a perfect system. No, where do we have them perfect? All I am saying is: Let us allow the nursing educational systems in the developing worlds to evolve, to grow with the world. It almost looks as if the world has left us all behind here, in the developing world, and we are struggling to meet up. The standards are poor and the system can not give us the solid foundation that we need to stand on - it's incapable.
If we do not do something, now, about it, we may have a future filled with nurses, in the developing worlds, who do not understand who they are.
Ayinla seeks to build an innovative healthcare community that focuses on the improvement of the image of the nursing profession through mentorship, partnership with organizations and bodies that share goals, and community. His major tool is writing. While still practicing as a critical care nurse in Nigeria and occupying the position of the editor of the Institute of Nursing Research Nigeria, he works as a freelance writer, focusing on nursing and healthcare, digital health, innovation, leadership, and personal development. When he is not in the intensive care unit, he is with his books, reading or writing, helping out with community projects (online and offline), enjoying worship in his local church, or sweating it out in the gym.
Connect with Ayinla
Ayinla can be reached via Twitter @Ayinla0 and via Care City.